소화기내시경 세부전문의 교육수련 가이드라인

Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy

  • 이기명 (아주대학교 의과대학 소화기내과학교실) ;
  • 최석렬 (동아대학교 의과대학 내과학교실) ;
  • 장병익 (영남대학교 의과대학 내과학교실) ;
  • 김성환 (을지대학교 의과대학 내과학교실,) ;
  • 강창돈 (강원대학교 의학전문대학원 내과학교실) ;
  • 김영대 (조선대학교 의과대학 내과학교실) ;
  • 박정엽 (연세대학교 의과대학 내과학교실) ;
  • 정일권 (순천향대학교 의과대학 내과학교실)
  • Lee, Kee-Myung (Department of Gastroenterology, Ajou University School of Medicine) ;
  • Choi, Seok-Reyol (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Jang, Byung-Ik (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kim, Seong-Hwan (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kang, Chang-Don (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Young-Dae (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Park, Jeong-Youp (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chung, Il-Kwun (Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 발행 : 2011.04.30

초록

1995년 후반 대한소화기내시경학회에서는 소화기내시경 세부전문의 제도와 세부 규정을 마련하여 현재까지 많은 세부전문의들을 배출하고 있으나 체계적인 교육목표와 지침이 미비하였다. 소화기내시경 세부전문의 수련과정에서 내시경 검사는 지도 전문의의 감독하에 실시되고 있지만, 수련기간 동안 여러내시경 검사와 치료법에 익숙해지기는 현실적으로 어려움이 많다. 또한 수련과정 후 독자적인 검사와 치료를 통한 체득과정이 더욱 중요하다. 따라서 지도 전문의 감독을 벗어나 소화기내시경 검사와 치료를 수행할 수 있는 지 여부를 판단할 만한 최소한의 가이드라인이 필요하다. 이에 대한소화기내시경학회 교육수련위원회에서는 안전하고 정확한 내시경 검사 및 치료를 위하여 세부전문의 수련과정 중에 반드시 알아야 할 최소한의 교육목표를 제시함으로써 지도 전문의 및 피교육자에 교육수련의 가이드라인 제공과 동시에 향후 내시경 검사와 치료의 질적 향상에 기여하고자 한다.

The Korean Society of Gastrointestinal Endoscopy (KSGE) developed regulations and a gastrointestinal endoscopy board in 1995. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. Although endoscopic examinations are supervised by a specialist during a GI fellowship, some types of GI endoscopic examinations and treatments are difficult to obtain exposure. Fellows should acquire endoscopic skills through repeated independent endoscopic examinations after a GI fellowship. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform endoscopic examinations without a supervisor. This document is intended to provide the principles that the Committee of Education and Training of KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. KSGE will contribute to improving the quality of GI endoscopy by providing guidelines for fellowships and supervisors.

키워드

참고문헌

  1. Gut Image Study Group, Lim YJ, Moon JS, Chang DK, et al. Korean Society of Gastrointestinal Endoscopy (KSGE) guidelines for credentialing and granting previleges for capsule Endoscopy. Korean J Gastrointest Endosc 2008;37:393-402.
  2. ASGE Standards of Training Committees. Principles of training in gastrointestinal endoscopy. Gastrointest Endosc 1999;49: 845-850. https://doi.org/10.1016/S0016-5107(99)70316-0
  3. Cass OW, Freeman ML, Peine CJ, Zera RT, Onstad GR. Objective evaluation of endoscopy skills during training. Ann Intern Med 1993;118:40-44. https://doi.org/10.7326/0003-4819-118-1-199301010-00008
  4. Cass OW, Freeman ML, Cohen J, et al. Acquisition of competency in endoscopic skills (ACES) during training: a multicenter study. Gastrointest Endosc 1996;43:308A.
  5. Wigton RS, Blank LL, Monsour H, Nicolas JA. Procedural skills of practicing gastroenterologists. A national survey of 700 members of the American College of Physicians. Ann Intern Med 1990;113:540-546. https://doi.org/10.7326/0003-4819-113-7-540
  6. Korean Society of Gastrointestinal Endoscopy. Enforcement rules about education for gastrointestinal endoscopy subspecialty and specification of education hospital for gastrointestinal endoscopy subspecialty. (http://www.gie.or.kr/medical/ sub02c.html).
  7. Buscaglia JM. The American Society for Gastrointestinal Endoscopy First-Year Fellows' Endoscopy Course: see one, do one, teach one? Gastrointest Endosc 2008;67:513-514. https://doi.org/10.1016/j.gie.2007.08.001
  8. Principles of training in gastrointestinal endoscopy. Manchester, Massachusetts: The American Society for Gastrointestinal Endoscopy, May, 1991.
  9. Hawes R, Lehman GA, Hast J, et al. Training resident physicians in fiberoptic flexible sigmoidoscopy. How many supervised examinations are required to achieve competence? Am J Med 1986;80:465-470. https://doi.org/10.1016/0002-9343(86)90721-7
  10. Chak A, Cooper GS, Blades EW, Canto M, Sivak MV Jr. Prospective assessment of colonoscopic intubation skills in trainees. Gastrointest Endosc 1996;44:54-57. https://doi.org/10.1016/S0016-5107(96)70229-8
  11. Lee SH, Chung IK, Kim SJ, et al. An adequate level of training for technical competence in screening and diagnostic colonoscopy: a prospective multicenter evaluation of the learning curve. Gastrointest Endosc 2008;67:683-689. https://doi.org/10.1016/j.gie.2007.10.018
  12. Marshall JB. Technical proficiency of trainees performing colonoscopy: a learning curve. Gastrointest Endosc 1995;42:287-291. https://doi.org/10.1016/S0016-5107(95)70123-0
  13. Tassios PS, Ladas SD, Grammenos I, Demertzis K, Raptis SA. Acquisition of competence in colonoscopy: the learning curve of trainees. Endoscopy 1999;31:702-706. https://doi.org/10.1055/s-1999-146
  14. Verma D, Gostout CJ, Petersen BT, Levy MJ, Baron TH, Adler DG. Establishing a true assessment of endoscopic competence in ERCP during training and beyond: a single-operator learning curve for deep biliary cannulation in patients with native papillary anatomy. Gastrointest Endosc 2007;65:394-400. https://doi.org/10.1016/j.gie.2006.03.933
  15. ASGE Committee on Training. ERCP core curriculum. Gastrointest Endosc 2006;63:361-376. https://doi.org/10.1016/j.gie.2006.01.010
  16. Rosenthal LS. Is a fourth year of training necessary to become competent in EUS and ERCP? Notes from the 2008 class of advanced endoscopy fellows. Gastrointest Endosc 2008;68:1150-1152. https://doi.org/10.1016/j.gie.2008.09.020
  17. Kowalski T, Kanchana T, Pungpapong S. Perceptions of gastroenterology fellows regarding ERCP competency and training. Gastrointest Endosc 2003;58:345-349. https://doi.org/10.1067/S0016-5107(03)00006-3
  18. ASGE. Guidelines for training in endoscopic ultrasound. Gastrointest Endosc 1996;49:829-833.
  19. ASGE. Guidelines for credentialing and granting privileges for endoscopic ultrasound. Gastrointest Endosc 2001;54:811-814. https://doi.org/10.1016/S0016-5107(01)70082-X
  20. Hoffman B, Wallace MB, Eloubeidi MA, et al. How many supervised procedures does it take to becom competent in EUS? Results of a multicenter three year study. Gastrointest Endosc 2000;51:AB139.
  21. Hoffman BJ, Hawes RH. Endoscopic ultrasound and clinical competence. Gastrointest Endosc Clin N Am 1995;5:879-884.
  22. Han DS. Necessity of quality control of gastrointestinal endoscopy and its present state. Korean J Gastrointest Endosc 2009;39(suppl):50S-52S.
  23. Korean Ministry of Health & Welfare. Guideline for colorectal cancer screening. 2008.
  24. Faigel DO, Pike M, Baron TH, et al. Quality indicators for endoscopic procedures: an introduction. Gastrointest Endosc 2006;63(suppl):3S-9S. https://doi.org/10.1016/j.gie.2006.02.017
  25. Faigel DO, Cotton PB; World Organization of Digestive Endoscopy. The London OMED position statement for credentialing and quality assurance in digestive endoscopy. Endoscopy 2009;41:1069-1074. https://doi.org/10.1055/s-0029-1215279
  26. Jung IK. Quality control of upper GI endoscopy. Korean J Gastrointest Endosc 2009;39(suppl):53S-61S.
  27. Kim YH. Quality control of colonoscopy. Korean J Gastrointest Endosc 2009;39(suppl):65S-70S.
  28. Moon JS. Quality control of cleaning and disinfection in gastrointestinal endoscopy. Korean J Gastrointest Endosc 2009;39(suppl):71S-73S.